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Testing Self-Help

One of my main research interests is the evaluation of self-help approaches. I want to know which self-help approaches work and which don't so that psychologists and life coaches can confidently recommend resources to consumers. In this blog post, I will give some examples of how this type of research is done so that, when I say "this is effective according to research," you have an idea of how I might have reached that conclusion.

One of the books we evaluated in a recent study published by my lab.

Last year, in collaboration with a student of mine, Rebecca Szanto, I did a study looking at how one positive psychology self-help book, The How of Happiness, worked to decrease depressive symptoms and to increase happiness in college freshmen. Participants were randomly assigned to read HoH or a book that focuses on correcting negative thinking and reducing depression symptoms (Control Your Depression). Each book provided a set of concrete activities to try, and we also gave participants a syllabus to follow for each week of the 8-week period they had to finish. We found that both books would work better than whatever people were doing naturally (we also had a no-book control group), but that participants liked HoH better because it focused on building new sources of happiness—which is somewhat more fun than trying to fix one's deficiencies (you can find the full paper here if you are curious).

I also published a paper in 2013 with my colleagues at UC Riverside looking at the effectiveness of a cell phone app called Live Happy, which was designed based on the content of The How of Happiness (you can find the actual paper here; it's Study 3). Participants were simply people who bought the app. We found that, not surprisingly, people who used the app more experienced more improvement in their mood. More interestingly, we found that people who chose a variety of activities benefitted more than people who spent the same amount of time practicing, but on a limited range of activities. This type of study is more realistic, but also less controlled—there's no control group, and participants didn't follow any set of instructions from us. They just did what they wanted when they felt like doing it.

Screenshots from the LiveHappy app, which we also studied in a recently published paper.

So research on positive psych activities varies quite a bit—there are studies that are in-person and on college students (not that realistic) and pretty controlled (they had a syllabus to direct their efforts each week), and there are studies that are realistic (a smartphone app being tested in people who buy it) but uncontrolled study. By combining these types of methodologies, we can get the best possible pictures of what works and what doesn't.

The current study I am working on hopefully provides a compromise between these two types of designs—the participants are people interested in happiness (like you, perhaps) and it'll be conducted over the web, where many popular self-help sites exist. If you are a self-help user or a person who wants to try a self-help approach, and you would be interested in participating in my current study, please visit this web page for more information. If you are a coach or therapist, please don't enroll in the study yourself (we are really interested in getting a realistic sample of self-help consumers), but you are welcome to forward the link to clients who you think might be interested.

Being somebody who is an avid self-helper, I will give a brief overview of the problems and pitfalls I have encountered. In my experience the advice I've been given to date has been extremely limited, I had 8 sessions with a psychoanalyst followed by 12 sessions with a counsellor, this was over about a 10 mth period - which helped to a degree, and although my depression appeared to be allieviated it was a superficial reprieve. During this time I started to take my issues into my own hands and read as much as I could about mental 'illness' and was immediately struck by the amount of similarities that existed. I extended my reading to co-dependence, toxic parents/families, narcissism, child development and so on and so forth. Whilst studying many deliberately targetted self-help books what became highly apparent was that the problem was me - Anthony Robbins Awaken the giant within is a great example of that. What was also very apparent was that all the positive affirmations in the world will only have negligible affects if you continue to BELIEVE that there is something 'wrong' with you. Hence the self help books have a tendency to reinforce the underlying belief. The problem is not what we think, but the unconscious belief that supports the thinking process. I found a thorough examination of belief systems to be highly beneficient, particularly where our beliefs originate, why and what is the long term impact of them. This particular line of inquiry has caused me to diversify my reading into many areas - such as history, pharmaceuticals, spirituality, nutrition, consciousness, archetypes and esoteric and occult literature. I do have to point out here that occult merely means hidden as opposed to the common misinterpreted view of it being evil.
It's of no surprise to me that people preferred the easier option, as this option relies on using existing neural pathways as opposed to creating new ones - and this is immensely hard work, even more so when the task is taken upon yourself and is unsupported by the mental health community that is supposed to be there to support you.
When we look at our inner environment there is an awful lot to process and become of aware of, getting to the core of the issue is a long healing process and I would be extremely wary of any quick fix solutions. I am personally about 3 years into this process and am guessing that I've still got a few years to go. For example Parsifal and the handless maiden were 'lost in the forest' for 5 and 7 years respectively before they managed to find the Fisher King's castle and the Grail. Crossing to Avalon is a very good read for women entering a 'mid life' crisis and has mass implications for societal systems and structures.
Which brings me to my next point, which is the tendency to ignore or diminish the massive affect of environmental impacts - friends/family/society/culture. After trawling through the shadows in my inner world, accept my projections and learn not to be so reactive it is now immensely apparent that the entire patriarchical systems that run through Western societies/cultures - that are accepted as the 'way it is' and 'normal' are highly abusive in their actions. I could give many examples to reinforce this point - but what it essentially boils down to is that all individuals, both those that are considered mentally ill and mentally healthy need to have a greater understanding of their own dark sides - without this understanding they continually reject the aspects of themself they are unconscious of and project these often unpleasant aspects of their 'self' out into the ether, the collective unconscious/archetypal realm - and as we can see by a quick flick through the newspapaers we have war/genocide/starvation/poverty etc. These actions are being propogated because people have no understanding of themselves or the systems that control them.
It's my personal view that anyone who wants psychological aid should be encouraged to take the 'difficult' path and this approach needs to be compassionate, diverse and holistic.
I also think we put too much weight on being 'happy' as this comes as a result of becoming whole in ourselves, resolving core issues, reconnecting to who and what we are. Reuniting ourselves with both our 'self' and our 'Self' can lead to far greater revelations than happiness, which, although a useful goal on the journey should not position itself as the ultimate goal, as the journey is itself the goal. In dealing with ALL of our emotions it can lead to realizations of awe/beauty/profound unconditional love and in addition we open ourselves to the density of pain/suffering and evil that is proliferated through our species and upon animate life upon this planet.
Becoming aware is a double edged sword that we have to learn to weild with both grace and honour. To hold the tension between opposites is not a skill we are taught, widely adopted Aristotellian logic does not deem this possible whereas Buddhist and Jain philosophy 'see' things very differently.

Hi, Helen. Thanks for your comment. I would disagree with your characterization of positive-based books vs. a cognitive therapy-based book as they impact neural pathways -- specifically, the assertion that a positive-based self-help book uses existing pathways while a cognitive-behavioral book requires the creation of new pathways. I actually get the sense that the opposite is true. For example: when people first start to record the good things that happen to them each day, particularly if they are depressed, they often report that this is a very difficult task. It's not something they are used to doing, and like anything else, it requires creating a habit, which is hard. If you are feeling down, it is not easy to find gratitude. It takes hard work. I would actually say that neither case involves using well-ingrained pathways you already have (the "easy way out" as you describe it). No depressed person has a well-used pathway for noticing the positive. That's part of why they are depressed! The difference is between creating new pathways (as you do in a pos. psych-based book) and CHANGING existing pathways -- when you do cognitive therapy, you are trying to rewrite old pathways that are very, very ingrained. In contrast to what you said about using existing pathways being easier, I would argue that it is much "easier" to create new pathways that to negate old pathways. You cannot reach the conclusion that your life is without merit if you also acknowledge that several good things happened to you in the day, and if you spend time contemplating the things you are grateful for, and if you deliberately cultivate pleasurable experiences, and if you do kind acts to make others' day better. Thus, you can impact depressive symptoms without actually having to grapple with the pathways that caused them; you simply create new, incompatible pathways. That's the theory, and there is certainly research evidence to back it up (not at the neural level -- I think of the "neural pathways" thing as a metaphor more than anything else -- but at the behavioral level). I would also encourage you to examine the belief, held by many people but supported by little data, that "easier" automatically means "bad" or "lazy" or "ineffective." Everyone has strengths and weaknesses, and when doing something that is a "strength" of yours, that means it comes more easily. Does doing something that comes naturally mean that you are somehow cheating, or are you simply being smart about where you direct your efforts by taking advantage of your positive qualities?

Here are some research papers that might be of interest to you, and that illustrate the idea of tackling depression using a strengths-based approach using theory and/or data (depending on which paper you read):

Thank you for your response - I don't actually aspire to CBT either. I've found a combination of Jung/Grof/Dabrowski/Graves/Wilber and Bucke, amongst others, to be more informative. I didn't mean to imply that changing negative to positive thoughts was an easy process rather that it neglects to deal with underlying causes. I also think that in some instances negative thoughts are highly valid, as indeed positive thoughts are. For example if I find myself in an abusive situation then I'm not going to think to myself that it's ok and 'things are good' for that would be giving my power to the abuser and allowing the abuse to continue. Being someone who has been suicidal and totally depressed I can see where you are coming from, but I disagree that - 'No depressed person has a well-used pathway for noticing the positive.' - I now have a highly developed pathway for noticing the most simplistic, beautiful and awe inspiring circumstances, and it is the creation of this pathway that takes the edge off my depression, it is a place I visit very frequently, which has given me inspiration to get highly creative. This positive way of thinking does not prevent me from wondering 'what's the point' or considering the implications should I choose to 'opt out' at some time or feeling utterly despondent and miserable at the amount of suffering that exists in the world. I agree that it's possible to impact depression without grappling with the pathways that cause it, but it also means that the depression may lie dormant and rear its ugly head later in life, and then it will be much worse. It's my feeling that depression and other mental illnesses arise when we become disconnected from who we are and fail to behave authentically, the reason we are unable to behave authentically is due to the brick wall system that our beliefs, lying in both the individual and collective unconscious, put in place. The beliefs being created from the environment family/social/cultural we are raised in. This belief system, whilst stubbornly persisting is nothing more than a thin veil that can be penetrated only when we realise its existence.
'You cannot reach the conclusion that your life is without merit if you also acknowledge that several good things happened to you in the day, and if you spend time contemplating the things you are grateful for, and if you deliberately cultivate pleasurable experiences, and if you do kind acts to make others' day better.' - again I disagree, whilst I've automatically integrated these actions into my life they neglect the deeper aspects that life requires meaning and purpose.
For example I would hope that you derive meaning and purpose from helping others overcome their problems, whereas perhaps someone who stacks shelves/works on a production line all day for a minimal wage would derive very little meaning or purpose from their work. As Adam Smith commented, the downside of specialization would create very uninspired and 'zombified' people. Meaning and purpose lie in the core of our being, beneath the beliefs that mask them and that's why I propose that it's essential to go deeper than thinking positively and becoming satisfied with our circumstances. It's necessary to empower others to discover their 'true self' and I've equated this to digging to the centre of the earth with bare hands.
I am in no way asserting that positive psychology is a bad thing, but I am saying that it is incomplete in it's outlook - it seems to me, to hold aspects of 'new age' spirituality. Simply put, if we think everything is great then it becomes great - that puts a hell of a lot of pressure on the person who is barely managing to keep a roof over their head and put food in their mouth - because it insinuates that they are the cause of their own problem and neglects to examine social/educational/economic and political factors that are maintaining a staus quo that is neglecting to help empower them to higher aspirations.
And finally 'I would also encourage you to examine the belief, held by many people but supported by little data, that "easier" automatically means "bad" or "lazy" or "ineffective." Everyone has strengths and weaknesses, and when doing something that is a "strength" of yours, that means it comes more easily. Does doing something that comes naturally mean that you are somehow cheating, or are you simply being smart about where you direct your efforts by taking advantage of your positive qualities?' I agree, but would add on the flip side that doing something that comes 'naturally', which I would suggest would be something inherent in the core of your being, can also be incredibly difficult when that thing has been totally alien to your existence for over 40 years.
Sorry to stray from the initial post so much - because I do think that self help can have a highly positive outcome and release much untapped potential - but for me, a high percentage of the self help books that I've encountered have been too limited and I only gleaned partial insight and answers from them, hence the necessity to dramatically broaden my search for answers that resonated with me. I do feel that this 'quest' has been necessary for me to attain to a greater level of understanding and am very much an adovocate of 'Know Thyself' and this is totally inclusive, warts and all.

Some very interesting and important thoughts, Helen. Certainly, positive psychology is not intended to address every possible problem -- the severest depression, the worst poverty or abuse, isn't going to respond to this type of approach. But it does work in mild-moderate depression quite robustly, which is kind of surprising on the surface.

And I completely agree -- when it comes to self-help, there is A LOT of schlock out there. I try to stick with the stuff that is directly based on research, and that has some research that has tested its effectiveness directly as well. It's a much smaller subset of books, but at least one can have reasonable confidence that it will have an impact.

Helen wrote: I also think that in some instances negative thoughts are highly valid, as indeed positive thoughts are.

I agree, Helen. If we think of Life as a decision-making process, the major problem in making any kind of decision is bias. A bias is anything which can throw judgment off its true course. Habitual optimism is a bias potentially as harmful as habitual pessimism.

We should strive for habitual realism which will allow us to see the evidence as it truly is, good or bad. Both pessimism and optimism should be based on a realistic view of the evidence. The positive thinking theme which has dominated the self-help industry for decades is poor advice.

Yes, both optimism and pessimism involve biases -- they come into play when we don't know what's going on and we have to guess. An optimist assumes it's probably good, and a pessimist assumes it's probably bad. Neither is going to be right all the time because both are guessing. Neither is inherently more or less accurate. So yes, we should strive for realism, and realism is possible in the context of both optimism and pessimism. There is no reason why optimism is inherently distorted, however (although there seem to be rumblings in the public consciousness about pessimists being "real" and optimists being "fake"). Here's an example of an article writing up research about "realistic optimism" if you're interested:

Thanks for the link. I read the article but was unimpressed. The term "realistic optimism" combines two views of the evidence that should be kept separated if they are to be understood.

Imagine that we have eyeglasses enabling us to view the evidence. We have dark lenses for habitual pessimism, rose-colored lenses for habitual optimism, and clear lenses for habitual realism. We can't combine the clear lenses with the rose-colored lenses for a different view than the rose-colored lenses would offer.

If someone is confident that they can handle most of the problems they encounter in Life, that confidence is evidence-based because they have been successful in handling problems in the past. Confidence is an effect. Success is the cause.

If people lack that confidence, it is because they have not been successful in solving their problems in the past. Advising them to become "realistic optimists" is like telling them they should have more confidence in themselves. It's pointless because they first need to succeed in solving their problems in order to gain confidence gradually.

I think the point is that a person who doesn't believe they can change things will never try in the first place. The success rate if you don't try is zero. So it's in a person's interest to have an overly charitable belief that they are able to effect change because then they are going to at least attempt to make that change.

When someone asks for help from a psychologist, isn't that a tacit declaration that they are not without hope? And, obviously, you can build that hope by giving them confidence in you. But, my point earlier was that teaching them to become a realistic optimist, or trying to pump up their weak self-confidence with words of encouragement will probably fail.You will have to help them build their self-confidence by leading them step-by-step until they get the hang of it.

You will need to give them a plan to achieve a goal they can reach. And once they have reached that goal, you give them another plan and a more ambitious goal. Then, repeat as needed. Then, once they see how it's done and that they can do it, they won't need you.

By the way, you have undertaken a worthy research project. There is a massive amount of nonsense being sold in the self-help industry. Good luck with it.

Excellent comments Joe, whilst I don't like labels the best one I've discovered for myself so far would be a 'Dynamic paradoxicalist'. When seeing your own beauty and warts then it also becomes very apparent of the beauty and warts that exist in the world and humanity. Recognising the interconnectedness of everything in existence can make it difficult not to be drawn along with the flow - sometimes going with flow means you end up in the sewage and I really would rather, in that instance, swim against the tide. If it's seen to be 'positive' to 'go with the flow' I'd rather take the 'negative' option.

I grinned on reading "dynamic paradoxicalist," Helen. I was sold on the idea even before you explained it.

I have never suffered from depression, so I can't relate well to the problem. However, there is one observation I can make that might be useful to you: Humanity is, and always has been, making moral progress. We humans are treating each other better today than at any time in the past. To see that, I suggest you ignore the daily news reports. Think of our cultural institutions separately. Are religions kinder to each other today than they were 500 years ago? Are Management and Labor getting along better than they were a few hundred years ago? Business ethics? Human rights?

When we humans make moral gains, we don't backslide. It's hard to imagine us returning to the days of Slavery and Child Labor abuses, for example. So, if the trend continues, and there's no reason it shouldn't, Humanity is headed inevitably toward global harmony (maybe not perfect harmony, but close enough). Morally, we have a long way to go, but I hope this optimistic worldview will ease your burden a bit.